Infection at the site of vascular anastomosis is a serious complication of vascular surgery and is associated with a high limb loss and mortality rate. The classical method of management is ligation of the injured artery, adequate wound debridement and restoration of circulation. The latter is achieved by either in situ or extra-anatomic bypass. If the distal circulation is not maintained, subsequent amputation is most likely.
Objectives: In this study we tried to assess the efficacy of extra-anatomic synthetic bypass grafts in the treatment of vascular infection in the groin to save the limb and avoid the inevitable amputation.
Methods: Between January 2006 and December 2007, ten male patients aged twenty to thirty five years (mean=27.3years), with previous vascular surgery (reversed saphenous vein grafting) for sub-inguinal penetrating injuries complicated with infection and bleeding were admitted and managed surgically in the Department of Thoracic and Vascular Surgery, Surgical Specialties Hospital, Medical City Teaching Complex, Baghdad. These patients were studied retrospectively regarding their demographic and clinical features as well as details of the operative procedures and surgical outcome.
All patients received emergency wound debridement, arterial ligation and extra-anatomic synthetic (PTFE) bypass grafts (External iliac or common femoral to distal superficial femoral or popliteal artery, six routed laterally and four routed medially in the thigh away from the original surgical field).
Results: Excellent results were obtained in nine patients who saved amputation while one patient ended with above knee amputation. No mortality recorded.
Conclusion: Extra-anatomic bypass is a useful approach in dealing with infected and disrupted vascular anastomosis and can be used in emergency as well as elective situations as mentioned in most literatures.
In recent years, the linguo-philosophical studies of metaphor have tended to define metaphor as an interaction of the object, that is the referent of conceptualization and some features that are associated with sensual manner realities, whose name is used when resolving the conceptual problem-nominative situation, namely the situation of the formation of a new concept and its verbalization. The objective of this term paper lies in the phenomenon of metaphors used in modern political discourse. In our understanding a metaphor is not only of a linguistic nature, but also political. This paper approaches the subject of conceptual metaphor and political argumentation through the prism of synergies of the political topic, affirmative or negative
... Show MoreThe Collapse of the Dreams in Ayad Akhtar’s Disgraced (2012) is a study that examines the theme of shattered dreams within the context of the play. Focusing on the protagonist Amir Kapoor, a successful Pakistani-American lawyer, and his journey from assimilation to self-discovery. This study explores the consequences of denying one's cultural heritage and the disintegration of personal aspirations. Through a close analysis of Amir's interactions with his wife, friends, and colleagues. This research investigates the underlying factors that contribute to the collapse of dreams and the unraveling of identity. By employing literary analysis and cultural criticism, the research sheds light on the complexities of cultural assimilation, racial i
... Show MoreDomestic violence, or as sometimes known as family abuse, is usually related to a domestic or local setting as in cohabitation or in marriage. It can take the forms of being physical, verbal, economic or emotional. Globally, most of the domestic violence is overwhelmingly directed to females as they tend to experience and receive severe forms of violence, most likely because they do not involve their intimate, or sometimes even non-intimate partners, in the process of mental and physical self-defense.
Sometimes countries justify domestic violence directed to females, they may be leg
... Show MoreResults: it was found that labelled cells participated in the formation of myotubes, which formed mature muscle fibers, and possibly new satellite cells. The results of this experiment may eventually revolutionized therapeutic procedures for some form of muscle diseases
Many studies have recommended implying the skills and strategies of creative thinking, critical thinking, and reflective thinking in EFLT curriculum to overcome EFL teaching-learning process difficulties. It is really necessary to make EFL teachers aware of the importance of cultural thinking and have a high perception of its forces. Culture of thinking consists of eight cultural forces in every learning situation; it helps to shape the group's cultural dynamic. These forces are expectations, language, time, modeling, opportunities, routines, interactions, and environment. This study aims to investigate EFL student-teachers’ perceptions of cultural thinking. The participants are selected randomly from the fourth-stage students at the D
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Agricultural development occupies an important position in the economies of developing countries, and its role is greater for the Arab countries. The first task is to provide food security for all the population through sustainable development, which includes the investment of available natural resources and employment opportunities for the rural population, As well as the provision of raw materials for agricultural processing in order to increase agricultural exports to reduce the balance of payments deficit. Sustainable development is linked to increased production and improvement, as well as to food security. On the one hand, it has to cope with the increase in population and if it is possible to achieve a surplus allocated for export, a
... Show MoreWords in a language do not exist in isolation but in close connection with each other ,teaming up in one way or another known to the Russian semasiology M. M. Pokrovsky , one of the first to realize the systematic nature of the lexicon, wrote about the second half of the nineteenth century : „the Words and their meanings do not live separate from each other life, but are joined together in our minds), regardless of our consciousness to different groups , and the basis for grouping is the similarity or direct contrast in the main value.